Large systematic review of antidepressants

Author: Shannen Stevens
Category: Medication Updates
Date: February 8, 2019

In 194 head-to-head RCTs, agomelatine, amitriptyline, escitalopram, mirtazapine, paroxetine, venlafaxine and vortioxetine were more effective than other antidepressants, whereas fluoxetine, fluvoxamine, reboxetine, and trazodone were the least effective. Agomelatine, citalopram, escitalopram, fluoxetine, sertraline and vortioxetine were better tolerated than others. Amitriptyline, clomipramine, duloxetine, fluvoxamine, reboxetine, trazodone and venlafaxine were associated with higher dropout rates.

The GRADE framework generally found the evidence to be moderate quality for agomelatine, citalopram, escitalopram and mirtazapine, and low to very low quality for amitriptyline, bupropion, clomipramine, nefazodone and vortioxetine.

The full review can be found on the Lancets website.


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